Provider Demographics
NPI:1356852925
Name:DAWSON, HOLLY MARIE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:MARIE
Last Name:DAWSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 COMMODORE DR
Mailing Address - Street 2:
Mailing Address - City:MC DONALD
Mailing Address - State:PA
Mailing Address - Zip Code:15057-2177
Mailing Address - Country:US
Mailing Address - Phone:724-462-6295
Mailing Address - Fax:
Practice Address - Street 1:447 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-2564
Practice Address - Country:US
Practice Address - Phone:724-258-2070
Practice Address - Fax:724-258-3582
Is Sole Proprietor?:No
Enumeration Date:2017-10-23
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP017729363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care